Pityriasis rosea is a disease of the skin. It is also known as rosacea.
What is pityriasis rosea?
Pityriasis rosea is an inflammatory skin disease. In medicine, it also goes by the names of florets or psoriasis. The disease starts abruptly and lasts several weeks, in some cases even several months. Children and young people between the ages of 10 and 35 are particularly affected by pityriasis rosea. Pityriasis rosea appears twice as often in females as in males. Pityriasis rosea occurs to the same extent in all regions of the world. The disease breaks out most frequently in the spring and autumn months. The typical features of rosea lichen include its scaly redness, which appears primarily on the upper part of the body.
Causes
The exact causes of pityriasis rosea could not be determined until now. Numerous physicians have suspected that specific human herpes virus types 6 and 7 are responsible for the skin disease. The pathogens, which bear the designations HHV-6 and HHV-7, have similarities to the herpes viruses HHV-1 and HHV-2, which in turn cause infections such as genital herpes and herpes simplex. The human herpes viruses have the property of continuing to hide in the human body after an initial infection. Certain triggers make it possible for the viruses to react again, which then reproduce and cause disease once more. Therefore, the pathogens HHV-6 and HHV-7 are also believed to have this ability. The initial infection is usually free of symptoms. By reactivating the herpes viruses, pityriasis rosea develops, as it were, from within the body. However, this requires certain triggers that have not yet been identified. Thus, pityriasis rosea occurs only in a few patients in whom the herpes viruses are present. Although there is basically no risk of infection from pityriasis rosea, it is conceivable that ill persons pass the viruses on to other people. After this symptom-free initial infection, the development of rosacea is then quite possible later on, provided that the germs are brought back into an active state by the certain triggers.
Symptoms, complaints, and signs
Pityriasis rosea first becomes noticeable by the development of a so-called primary medallion on the trunk of the body. This refers to a primary spot that is approximately one centimeter in size. In some patients, the spot also appears on the abdomen, the back, the hairline, the inner side of the forearm or on the thighs. As it progresses, the primary medallion increases in size and develops a reddish scaly ruff. Because the scaling is directed inward, it is often overlooked. One to two weeks later, additional scaly redness forms in an elongated or oval shape. However, they turn out considerably smaller than the primary medallion and reach a maximum diameter of one centimeter. As a rule, they are found on the upper body. In some cases, they also express themselves on the areas of the thighs and upper arms close to the trunk, extending transversely in the direction of the body axis. The spots do not usually cause itching. If they do, it is usually of a minor nature. However, when the skin dries out due to intense bathing or sweating, more severe itching may occur, associated with severe redness. Other symptoms of the disease, such as headache, loss of appetite or fatigue, appear only in rare cases. Overall, pityriasis rosea is classified as a harmless disease. However, there is a danger for the unborn child during pregnancy, which is especially true for diseases before the 15th week of pregnancy (SSW). Thus, there is a risk of premature birth or miscarriage. After the 15th SSW, significantly fewer complications occur.
Diagnosis and course of the disease
The physician can usually make the diagnosis of pityriasis rosea on the basis of the typical symptoms. For this purpose, the patient is thoroughly questioned and examined. An important role is played by the distribution of the redness over the body and whether a single change is larger than the others. In addition, the doctor wants to know about other symptoms. If there is any doubt, a biopsy (tissue sampling) of the skin can be performed. The sample is then analyzed microscopically.The course of pityriasis rosea is positive. Even without therapy, the skin disease heals within three to eight weeks. Sometimes, however, the scaly redness remains on the skin for several months. Then they also regress again.
Complications
Due to pityriasis rosea, affected individuals usually suffer from skin complaints. These can appear on different regions of the body and usually lead to a significantly reduced quality of life of the patient. Those affected suffer from patches that have a reddish color. The spots themselves are not itchy or may even flake. In many cases, patients are ashamed of the symptoms of pityriasis rosea and thus suffer from reduced self-esteem or even inferiority complexes. This can lead to depression or other psychological complaints, especially in children. The skin itself is very dry and susceptible to various infections. In many cases, pityriasis rosea also leads to a loss of appetite or headaches. Permanent fatigue can also occur due to the disease and has a very negative effect on the patient’s daily life. The treatment of pityriasis rosea is carried out without complications with the help of medication. As a rule, a positive course of the disease is achieved relatively quickly. However, the disease may recur later in the life of the affected person.
When should one go to the doctor?
Pityriasis rosea must always be treated by a doctor. This can prevent further complications and discomfort. Here, early diagnosis and treatment have a very positive effect on the further course of the disease. A doctor must be consulted in the case of pityriasis rosea if the affected person suffers from spots on the skin that appear without any particular reason and do not disappear again on their own. The spots can appear in very different places and thus also negatively affect the aesthetics of the patient. Frequently, scales also appear on these patches and the patches are associated with itching. Severely dry skin may also indicate pityriasis rosea and must be treated by a physician. The disease is also manifested by permanent fatigue and loss of appetite. Usually, pityriasis rosea is treated by a general practitioner or by a dermatologist. The disease can be treated relatively easily, so in most cases there is a rapid positive course of the disease without complications. The patient’s life expectancy is usually not reduced as a result.
Treatment and therapy
As a rule, pityriasis rosea does not require any special treatment, as it heals on its own. However, it is considered useful to regularly apply a nourishing cream to the skin, which causes an improvement of the itching as well as the scaling. To avoid skin irritation, it is recommended to avoid hot and long baths or showers. The same applies to visits to the sauna or sports activities that trigger heavy sweating. Wearing clothes that are too tight can also have an unfavorable effect. The active ingredient polidocanol is recommended for the treatment of itchy redness. A weak cortisone preparation can also provide relief. In the case of extreme itching, light therapy is considered useful.
Outlook and prognosis
Pityriasis rosea is also known as rosacea or Gilbert’s disease. The prognosis for this skin lichen is generally good. Pityriasis rosea is neither contagious nor dangerous. It is known that the inflammatory reddened and scaly foci heal on their own within six to eight weeks. Therefore, the prognosis for pityriasis rosea is extremely good. In a very small number of cases, erysipelas recurs at some point. However, this is the case in no more than 2 percent of those affected. It is mainly women rather than men who are affected by pityriasis rosea. Pityriasis rosea usually occurs at a young age, between the ages of ten and 35. Why pityriasis rosea or pityriasis recurrence occurs has not yet been clarified. The onset of the disease usually lies in a single altered skin area. This is called by medical experts a “primary medallion” or “mother plate”. Thereafter, the inflamed areas continue to spread. Only the face, as well as the hands and feet, are left out of the red-rimmed inflamed areas.The disease is described by physicians as self-limiting. Treatment is usually not necessary due to the absence of symptoms. The prognosis for rose lichen is good even in the presence of itchy house patches. If necessary, these can be treated with ointments for itching.
Prevention
Prevention of pityriasis rosea is not possible because the exact causes of the skin disease are not known. Pregnant women should consult their gynecologist quickly in case of disease.
Aftercare
In most cases of pityriasis rosea, only very few measures of aftercare are available to those affected. In the first place, the disease should be detected and treated by a doctor at an early stage, so that it does not lead to further complications or other complaints. The earlier a doctor is consulted, the better the further course of the disease usually is. Affected persons should therefore see a doctor at the first signs and symptoms of the disease. In most cases, pityriasis rosea is treated by applying various creams and ointments. The affected person should always follow the doctor’s instructions and observe a correct dosage with a regular application. In case of ambiguity or questions, a doctor should be consulted first, and the doctor should also be consulted in case of side effects. As a rule, in the case of pityriasis rosea, regular checkups by a doctor are very important to monitor the condition of the skin permanently. The disease usually does not reduce the life expectancy of the affected person, although a general prediction about the further course can usually not be made.
What you can do yourself
Direct self-help is usually not available to the affected person with pityriasis rosea. Treatment is also not readily available, as the disease is still largely unexplored. However, the symptoms usually disappear on their own after a short period of time. The patient can regularly apply a moisturizer to his skin to alleviate the discomfort and speed up the healing process. Likewise, the skin should not be scratched despite the itching, as this will only further damage the skin. Hot and long baths should also be avoided. If possible, the patient should also avoid showering or wash the skin only with a pH-neutral lotion. In some cases, preparations containing cortisone can also be used to relieve the symptoms of pityriasis rosea. Tight clothing should also be avoided. The patient should also avoid strong and direct sun exposure to further damage or irritate the skin. The disease cannot be actively prevented and it may recur in the course of life. Further measures are usually not necessary.
